Respiratory Infections Flashcards
(55 cards)
What is the prevalence of pneumonia in children?
15% of all deaths of children under 5 year olds worldwide
How does pneumonia reach the lungs?
inhalation of aerosolized material or aspiration, less commonly the lungs are seeded with microorganisms from the blood; NOT airborne infections
What is CAP?
community-acquired pneumonia
What is HAP?
hospital-acquired pneumonia; onset of symptoms > 48 hours from admission
What is HCAP?
healthcare acquired pneumonia that happens with exposure to healthcare system within prior 90 days
What is VAP?
ventilator-associated pneumonia; onset of symptoms > 48 hours from intubation
What are the types of pneumonia?
bacterial, viral, and fungal
What are risk factors for pneumonia?
oldest and youngest, coexisting illnesses, and alcohol use
What are CAP signs and symptoms?
Typical: productive cough, dyspnea, chills, chest pain, fever, tachycardia, tachypnea, rales, and leukocytosis
Atypical: headache, malaise, confusion, poor appetite (all seen commonly in the eldery)
What are the stages of pneumonia?
1) congestion, 2) red hepatization, 3) grey hepatization, and 4) resolution
Explain the congestion stage of pneumonia
first 24 hours, bacteria present in lungs, immune system can take care of infection
Explain the red hepatization stage of pneumonia
first 2-3 days, lungs become more dry/granular and airless
Explain the grey hapatization stage of pneumonia
lasts 8 days, lungs acquire a grey or yellow color
Explain the resolution stage of pneumonia
lasts 8-10 days, the fluids and breakdown products from cell destruction get reabsorbed
What is the most important diagnostic test for pneumonia?
chest radiograph; pleural effusions, adenopathy and cavitary lesions can be all be seen with pneumonia
How do we decide CAP severity?
severe CAP is diagnosed by > 3 minor criteria or 1 major criteria
What tests do we currently have for CAP?
sputum gram stain/culture, blood cultures, antigen detection, serology, and molecular tests (NAT)
Why is taking a sputum specimen tricky?
it’s hard to obtain a good specimen and it can be overgrown by other normal flora, you also need to do it before starting antibiotic therapy
Where/when should you get sputum from?
you want deep sputum, obtain sample in the morning before breakfast
What bacteria cause typical CAP?
Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (respond to ceftriaxone)
What bacteria cause atypical CAP?
Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila (B-lactam resistant, treated with macrolides or quinolones)
How does Streptococcus pneumoniae (pneumococcal) cause pneumonia?
most commonly identified, GP diplococci, the nasopharynx is a key reservoir; increased risk of drug resistance in elderly, diabetics, prior antimicrobials, alcohol use, and daycares
How do we test for pneumococcal pneumonia?
use immuno-chromatographic detection of cell wall polysaccharide from urine or CSF * doesn’t always detect just current infections - confirms the patient has had it as some point
What do we use to treat drug resistance Pneumococcus?
for severe infections (like meningitis) combination therapy is used until sensitivity is known, usually ceftriaxone + vancomycin
